Clinical approach to a patient with infection

Question 1

When to suspect an infection in patient consultation

Answer 1

history of fever rigors, evidence of inflammtion, enlarged lymph nodes, sepsis signs, (fast pulse, hypotension, rapid breathing confusion)

Question 2

apart from infection what can be causing fevers

Answer 2

non infectious causes e.g sle

Question 3

what are the key parts of travel history when concerned about infection

Answer 3

travel, where to
when did you go timeframes matter due to incubation periods,
what did you do
backpackers at more risk than business ppl in hotels

Question 4

what are the key parts about exposure when concerned about infection

Answer 4

health of siblings, parents, animal bites, water being drunk is it clean, contact with ill people/animals and pets such as cats(bartonellosis)

Question 5

what do we want to know about the patient or host body of potential infection

Answer 5

Is your patient’s ability to fight infection reduced?
• Diabetes mellitus
• Renal transplant (taking immunosuppressing drugs e.g. steroids)
• Liver cirrhosis
• Absence of spleen (e.g. splenectomy)
• Advanced malignancy

Question 6

what areas are important in clinical examination of patient with suspected infection

Answer 6

general appearance do they look ill, signs of sepsis, ears throat, lymph nodes, neck stiffness(meningitis), pneumonia signs (dull on percussion), abdomen is it tender and skin signs of cellulitis

Question 7

Priorities when assessing patients with

infection

Answer 7

is infection life threatening, sepsis or organ infection, they may need iv abx fluids and icu,

is the patient an infectious risk to others, do they need to be isolated or for public health to be notified

Question 8

investigation for suspected infections

Answer 8

Bacterial cultures – blood, urine, throat swab
• Viral tests – direct detection using PCR, detection of antibodies
• Fungi – culture, antigen detection, antibodies
• Parasites – look for the bugs in blood (malaria), stool, antibodies